Financial | Financial Resources

Financial Questions

After a brain injury, many people face significant financial struggles and challenges that may seem overwhelming. This section discusses different governmental and independent financial resources and options for persons with brain injury and their families. You are encouraged to consult with a qualified attorney or financial planner to structure a solid financial plan.

All financial programs have an appeals process for individuals who have been denied benefits. It is very common for persons with brain injury to appeal financial decisions.

If you think that you should be eligible and have been denied benefits, you are encouraged to begin the appeals process with the appropriated agency. Please do not feel that you are ìcomplainingî or ìbeing difficult.î The appeals process is there for a reason.

Supplemental Security Income (SSI)

Supplemental Security Income (SSI) is a strictly need-based federal financial assistance program for persons with disabilities who have limited resources. The program is intended to guarantee a minimum monthly income level to disabled persons who have little or no income and resources.

Persons with disabilities can be eligible for SSI even if they have never worked. Age is also not a factor. If a person is eligible for SSI, he or she is automatically eligible for Medicaid. People receiving SSI must meet certain income and resource limitations to be eligible. Insurance policy payments, court settlements, worker's compensation, and other financial resources may limit your eligibility for SSI.

To apply for SSI, call your local Social Security Administration (SSA) office. To find out where the nearest SSA office is located, call (800) 772-1213 or see the Administration's web site at www.ssa.gov.

Social Security Disability Insurance (SSDI)

To qualify for Social Security Disability Insurance (SSDI), a person must have a physical or mental impairment that is expected to keep him or her from doing any substantial work for a least a year, or a condition that is expected to result in death. The amount of a person's SSDI payment depends upon how much he or she has worked and how much he or she has paid into the Social Security system through taxes.

A knowledgeable financial planner or lawyer should be able to assist you in structuring a compensation plan that will allow you to keep eligibility for government benefits. When choosing a financial planner or attorney, be sure to ask questions.

It is advised that you apply for SSDI benefits as soon as possible due to a six month waiting period. Monthly benefits begin on the sixth full month of the disability.

To apply for SSI, call your local Social Security Administration (SSA) office. To find out where the nearest SSA office is located, call (800) 772-1213 or see the Administration's web site at www.ssa.gov.

Medicare

Medicare is a federal health insurance plan that includes people with disabilities that are determined to be eligible for SSDI due to a disability. Medicare is not based on income. Medicare has two components: hospital insurance (called Part A) and medical insurance (called Part B). Local Social Security Administration offices process applications and provide information about the program.

To be eligible, a person must have been entitled to SSDI benefits for 24 months.

Hospital Insurance (Part A)

Any person who has been receiving SSDI for 24 months automatically becomes eligible for Medicare hospital insurance at no monthly cost without an application process. Medicare will help pay for the following health care options:

Hospital Inpatient Care: The 2000 deductible for hospital inpatient services is $776 per benefit period. After the deductible is met, Medicare pays 100 percent of the first sixty days of inpatient care. Medicare will pay all but $194 a day for the 61st to the 90th day and all but $388 a day for the 91st to the 150th day of inpatient care. Medicare pays nothing beyond 150 days.

 

Skilled Nursing Home Care: Medicare pays for 100 percent of the first 20 days. For the 21st to the 100th day, Medicare pays all but $97 a day. Medicare pays nothing beyond 100 days. To qualify, the recipient must require a skilled level of care or rehabilitative services as ordered by a physician. The recipient must also have had a hospital stay of three days or longer.

Home Health Care: Medicare can pay for a limited amount of skilled nursing care and physical, occupational, and speech therapies in the home. Medicare pays for 20% of approved durable medical equipment.

Hospice Care: Medicare covers both inpatient and home care services. There are no deductibles. Information on requirements for certification and covered benefits is addressed in a booklet published by the Social Security Administration. For a copy,

call (800) 772-1213 or visit www.medicare.gov.

Medical Insurance (Part B)

After receiving SSDI benefits for 24 months, a person with brain injury may choose to enroll in the Medicare medical insurance program (Part B). In 2000, the monthly premium for medical insurance benefits was $45.50. There is an annual deductible of $100 per year. If a recipient does not want the medical insurance program, he or she must refuse it in writing. After the deductible is met and premiums are paid, Medicare will cover:

  • Doctor's Services: The insurance covers an unlimited number of visits to the doctor for the following purposes, surgical services, diagnostic services, and other doctor-administered services. Medicare pays 80 percent of allowable or approved charges after the annual deductible of $100.

  • Other Services: Services covered include ambulance transport, home health visits, outpatient services such as emergency room or clinics, and certain durable medical equipment.

    Medicare coverage does not include any prescription drugs, custodial care, dental care, eye or hearing care or aids, or routine physical checkups. Some persons decide to buy supplemental Medicare insurance from a private company. Others may be eligible for Medical Assistance.

    Programs for Children

    For information about programs for children call the Department of Health.

    Medical Assistance (Medicaid)

    Some persons will be eligible for Medicaid. Medicaid is a need based program that may pay for routine physical examinations, eyeglasses, dental care, mental health services, medical equipment, home health care, inpatient and outpatient hospital services, nursing home services, prescribed drugs, occupational, physical, and speech therapy, and transportation to and from medical appointments.

    Waivers

    Waivers are a funding source usually targeted toward a specific age, income group, or other variable. There are waivers for which you may be eligible, including Developmental Disability (DD) and TBI waivers. You must be on medical assistance to get waivers. Do not worry if you have never heard of these waivers. Ask your case manager to explain which waivers for which you may be eligible. You may also call the Brain Injury Association at (708) 344-4646 or (800) 699-6443.

    Department of Veterans Affairs (VA)

    The Department of Veterans Affairs, formerly known as the Veterans Administration, is a federal program that provides benefits to eligible veterans and their eligible dependents. A honorable or general discharge will qualify a veteran for benefits. Veterans in prison or on parole may be entitled to certain VA benefits.

    Eligible veterans may receive acute rehabilitation, residential care, outpatient treatment, dental treatment, alcohol and drug treatment, prosthetic devices, or mental health services. The VA has a system that prioritizes who can receive services and at what time. Since there are limited numbers of beds available in VA facilities, there are often waiting lists for services.

    For more information about eligibility and services, call the VA at (800) 827-1000.

    Workers Compensation

    Workers Compensation Program is an insurance program provided by many employers at no cost to the employee. If an employee is hurt on the job or develops a disease due to conditions on the job, Workers Compensation pays all reasonable and necessary medical care related to the injury or illness.

    After a brain injury that happens on the job, a person or his or her family should let the employer know as soon as possible that an injury has occurred. Many employers require that an employee report his or her injury within 24 hours. The worker should only seek treatment at approved medical facilities. The worker must report any earnings, Social Security benefits or unemployment compensation benefits to the insurance company. These forms of income can affect the amount of Workers Compensation benefits received.

    Financial Organizations

    Champaign County Health Care Consumers

    44 E. Main St., Suite 208

    Champaign, IL 61820

    Telephone: (217) 352-6533

    Fax: (217) 352-9745

    Email address: cchcc@prairienet.org

    Web address: www.prairienet.org/cchcc

    Contact: Ms. Claudia Lennhoff

    Persons served: anyone

    Brief description: CCHCCs consumer health hotline works to provide education, advocacy, referral and empowerment to consumers having problems with any part of the healthcare system. The Dental Referral Program connects low-income residents with discounted dental care. CCHCC also uses community organizations to work toward quality, affordable health care for all.

    Accessibility: yes

    Hours: Monday-Friday, 9 a.m.-5 p.m.

    Community Service Center

    Northern Champaign County

    217 N. Garrard

    Rantoul, IL 61866

    Telephone: (217) 893-1530

    Fax: (217) 893-8600

    Contact: Mrs. Karen Kelly

    Persons served: residents of northern Champaign County

    Brief description: The Community Service Center is a multi-agency center which provides mental health, social, health and welfare services to residents of northern Champaign County. Some of the services include information and referral, an emergency food pantry, transportation assistance, a juvenile delinquency prevention program and holiday assistance.

    Qualifications: Resident of one of the 9 north townships in Champaign County

    Accessibility: Agency office is fully accessible; vehicles do not have wheelchair lifts

    Hours: Monday-Friday, 8:30 a.m.-5 p.m.

    Consumer Credit Counseling

    410 N. Water, Suite A

    Decatur, IL 62525

    Telephone: (800) 959-CCCS (2227)

    Fax: (217) 425-4793

    Email address: cccsdecatur@juno.com

    Web address: www.cccspeoria.org

    Contact: Mrs. Sharon Law

    Brief description: Our agency's mission is to provide a non-profit community service dedicated to delivering professional consumer credit education, confidential counseling and debt management programs to all people of the community, regardless of ability to pay.

    Fees: Counseling services are free; Debt management program is on a sliding scale $15-$40 per month depending on size of debt and income.

    Accessibility: Handicap accessible

    Hours: Monday-Friday, 8:30 a.m.-5 p.m.; Evening hours available

    Consumer Credit Counseling Consumer Credit Counseling

    4 North Vermilion #602 Robeson Building

    Danville, IL 61832 206 North Randolph Suite M100

    Telephone: (217) 431-2838 Champaign, IL 61820

    Telephone: (217) 398-2227

    Covenant Medical Center

    Case Management

    1400 W. Park St.

    Urbana, IL 61801

    Telephone: (217) 337-4597

    Department of Human Services

    801 N. Walnut

    PO Box 1787

    Champaign, IL 61820

    Telephone: (217) 278-5605

    Fax: (217) 278-5661

    Contact: Mrs. Jill Johnson

    Persons served: Champaign County residents

    Brief description: Cash, medical and food stamp benefits to qualifying individuals

    Qualifications: Varies from program to program

    Accessibility: Handicap accessible

    Hours: Monday-Friday, 8:30 a.m.-5 p.m.

    Energy Hotline Grants Management

    City of Urbana

    115 Main St. Suite 200

    Urbana, IL 61801

    Telephone: (217) 384-2447

    Family Service-First Call For Help

    405 S. State St.

    Champaign, IL 61820

    Telephone: (217) 352-6300

    TTY: (217) 352-0160

    Fax: (217) 352-9512

    Email address: family-service@prairienet.org

    Web address: www.prairienet.org/family-service

    Contact: Mary Anne Wilson

    Persons served: Anyone requesting service

    Brief description: Provides information about community resources, referral and advocacy for those needing services from other agencies. Also provides assessment of client needs for other agencies upon their request and coordinates charitable donations. Provides limited emergency assistance when available to qualifying individuals, including referral to food pantries, rent, utility bill and prescription medication assistance and bus passes for local transportation. Publishes the print version of the Help Book annually with the News Gazette. The Help Book is also available on-line at www.helpsource.org.

    Qualifications: Resource information is primarily for Champaign County

    Accessibility: Wheel chair accessible

    Hours: Monday-Friday, 8:30 a.m.-5 p.m., answering machine after hours

    Rent Assistance Program

    805 S. Sixth

    Champaign, IL 61820

    Telephone: (217) 328-0414

    Social Security Administration

    101 Country Fair Dr. 1001 E. Voorhees

    Champaign, IL 61821 Danville, IL 61832

    Telephone: (217) 398-5388 ext. 6 Telephone: (217) 443-0193

    Fax: (217) 373-4409

    Email address: Debra.Fleig@ssa.gov

    Web address: www.ssa.gov

    Contact: Debra Fleig

    Persons served: Champaign office serves Ford, Champaign, Douglas & Coles counties

    Brief description: Social Security is a pension program payable to people who have paid into the system long enough to qualify for a benefit. Benefits are payable for retirement, survivors and disability. The amount of the benefit is based on the amount of your earnings while paying into Social Security.

    Qualifications: There are different qualifications for each type of benefit, although the person applying for benefits must have worked under the system for a specific time period no matter what the benefit being applied for.

    Insurance: Medicare is offered to people 65 and older or who have been on disability for 2 years or longer. In addition, some people who have had a kidney transplant or are on dialysis may qualify.

    Accessibility: Call toll-free (800) 772-1213 or call or visit your local office.

    Hours: Champaign -- Monday-Friday, 9 a.m.-4 p.m.

    The Salvation Army

    855 East Fairchild

    Danville, IL 61832

    Telephone: (217) 442-5911

    Fax: (217) 442-4260

    Contact: Ms. Sharon Sawka

    Persons served: Vermilion County residents

    Brief description: This program is based on emergency one-time help for specific needs depending on available funding. Services include help with past rent, helping with power and limited prescription assistance.

    Qualifications: dependant on services needed

    Accessibility: Handicap accessible

    Hours: Monday-Friday, 8:30 a.m.-noon and 1-4:30 p.m.